Organization
PRUITT CO. OF ADA, INC
Active
Other names
PRUITT CARE
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY PRUITT PRENTICE (OWNER/CORPORATE OFFICER/MANAGER)
(580) 332-3523
Entity
Organization
Contact information
Practice address
402 E 12TH ST, ADA, OK 74820-6602
(580) 332-3523
(580) 310-0730
Mailing address
3900 N BROADWAY AVE, ADA, OK 74820-1110
(580) 332-3523
(580) 310-0730
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
11/09/2005
Last updated
04/20/2008
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